Gregory M. Bogdan, Ph.D. Research Director Rocky Mountain Poison and Drug Center Denver Health

1. Colorado’s Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange Gregory M. Bogdan, Ph.D. Research Director Rocky Mountain Poison and Drug Center Denver Health Denver, CO

2. Public Risk Perception Hotline Contacts (% population) Event specifics (bioterrorism, child-targeted, new emerging disease) will effect the amount of public concern and numbers of people having information or others needs.

3. Challenge for Preparedness • 2004 Redefining Readiness Project* • 60% of public would not heed official instructions to get vaccinated during smallpox outbreak • 40% of public would not heed official instructions to shelter in place during a dirty bomb incident * R. Lasker, Center for the Advancement of Collaborative Strategies in Health (www. cacsh.org)

4. Public Needs Information on….. • General topic/event information • Public health messages • Personal and family protection • State/local health dept guidelines • Points of contact for referral agencies • Health decision-support and evaluation

5. “Natural Fits” • Poison control centers • Nurse advice lines • Drug information centers • Public health agencies

6. How a Medical Call Center Works Hospitals & Healthcare Facilities M C C General Public patient surges reduced by providing information and triage through multiple paths Voice Fax Video Email Web Fax Email Voice Web Video Health Professionals Local & State Public Health Agencies

7. COHELP Objectives • Develop a standardized and prepared response to public health events • Provide consistent, accurate information • Collect and maintain structured data to better characterize events and responses • Develop capability and capacity to adapt to emerging public health emergencies

8. COHELP Service Users Public Healthcare Providers COHELP 877-462-2911 Clinics Schools Health Agencies Hospitals & EDs

9. Referral Procedures Caller COHELP Poison Center Nurse Line Local Health Agencies CDPHE Healthcare Providers

10. Provides 1-on-1 Information Toronto – SARS outbreak, Mar to Jun 2003 Total Calls = >300,000 Peak Daily Calls = 47,567 Deaths: 44 Cases: 438 COHELP – Two Outbreaks, Jul to Dec 2003 Total Calls = 36,170 West Nile Virus (WNV) Calls = 12,555 Deaths: 47 Cases: 2,543 Influenza/Pneumonia Calls = 23,615 Deaths: 809 Cases: 11,427

11. Reduces Hospital Surge • United States Poison Control Centers • Of 2.4 million contacts about potential toxic exposures, 1.8 million (75%) were managed outside of health care facilities • Denver Health Nurse Line • Manages 40% of callers at home • 70% callers changed plans • 16% planned home care but 47% chose it after calling

12. Other Benefits • Standardized, accurate information delivery • Call center infrastructure/technology • Adaptability • Integrated Web sites (www.cohelp.us) • Trained information providers • Defined referral procedures • Structured data collection and reporting

13. Lessons Learned • Public health events will continue to occur and will require a response • Need structured, coordinated systems to respond to these events that are: • Cost-effective • Efficient • Accurate • Consistent • Adaptable

14. More Lessons Learned • Call volume driven by event specifics and media attention • Easy to adapt messages to meet evolving public health and public needs • Surveillance • Ongoing surveillance signals • call volumes, topics requested, collected data • Sentinel event system • can identify new health concerns

15. For More Information • “Health Emergency Assistance Line and Triage Hub (HEALTH) Model” report on AHRQ Web site by end of year • www.ahrq.gov • HEALTH Contact Center Assessment Tool on HSRNET or AHRQ Web sites • www.hsrnet.net/ahrq/surgecapacity/event3/resource.htm (available now) • www.ahrq.gov (available by end of year)